Background: Adherence to inhaled medication is essential for optimal management of COPD and asthma patients as it helps control symptoms, minimize exacerbations, and inform clinical decision-making for improved patient outcomes
Objectives: The study aimed at implementing and evaluating a newly developed and validated inhaled medication adherence questionnaire for chronic respiratory diseases.
Methods: A randomized controlled trial (RCT) was performed to assess the efficacy of inhaled medication in a sample of out-patients diagnosed with asthma and COPD at Department of respiratory medicine, JSS Hospital. The study population was screened and then randomly divided into four distinct groups, comprising of two control arms and two intervention arms, based on their respective diagnosis. At baseline, and during two subsequent follow-up (after 3 and 6 months), the patients were administered the Medication Adherence Rating Scale (MARS) and a newly developed and validated questionnaire, the Inhaled Medication Adherence Questionnaire (IMAQ). Clinical pharmacists provided counselling to the intervention groups of both asthma and COPD patients regarding strategies to overcome medication adherence barriers, the proper use of inhalers, and the importance of medication adherence. The collected data was analysed using inferential statistics and the mean scores were compared using one-way ANOVA.
Results: A total of 150 patients were enrolled in the study, with 142 patients completing it. The average age of the study participants was 55.32 ± 9.46 years. This highlights the significance of adherence as a determining factor in the therapeutic outcomes for these patients. Of the study sample, 47.33% reported illiteracy, and 62.7% belonged to lower, upper lower, or lower middle socio-economic classifications. These demographic characteristics increase the likelihood of medication non-adherence, as the cost of inhaled medications can pose a significant financial burden. At the baseline, there were no significant differences in the mean scores of the MARS and IMAQ questionnaires among the four groups. However, after final follow-up, a significant improvement (p < 0.05) in mean scores was observed in intervention groups, indicating improved medication adherence. An analysis showed most frequent non-adherence causes were socio-economic factors (57%) followed by patient-related factors like stigma and lack of knowledge (36%).
Conclusions: This study finds that the newly developed IMAQ questionnaire is equally effective in measuring changes in adherence as the established MARS questionnaire, and it has the added benefit of identifying factors that contribute to non-adherence.
